Reduction has long been a favourite method of analysis in all areas of philosophy, but in recent years there has been a reaction against it. The contributors to this volume examine the motivations for such anti-reductionist views and assess their coherence and success in a number of fields.

In contemplating any life and death moral dilemma, one is often struck by the possible importance of two distinctions; the distinction between killing and “letting die”, and the distinction between an intentional killing and an action aimed at some other outcome that causes death as a foreseen but unintended “side-effect”. Many feel intuitively that these distinctions are morally significant, but attempts to explain why this might be so have been unconvincing. In this paper, I explore the problem from an explicitly (...) consequentialist point of view. I first review and endorse the arguments that the distinctions cannot be drawn with perfect clarity, and that they do not have the kind of fundamental significance required to defend an absolute prohibition on killing. I go on to argue that the distinctions are nonetheless important. A complete consequentialist account of morality must include a consideration of our need and ability to construct and follow rules; our instincts about these rules; and the consequences (to the agent and to others) that might follow if the agent breaks a good general rule, particularly if this involves acting contrary to moral instinct. With this perspective, I suggest that the distinctions between killing and letting die and between intending and foreseeing do have moral relevance, especially for those involved in the care of the sick and dying. (shrink)

There has been much debate regarding the 'double-effect' of sedatives and analgesics administered at the end-of-life, and the possibility that health professionals using these drugs are performing 'slow euthanasia.' On the one hand analgesics and sedatives can do much to relieve suffering in the terminally ill. On the other hand, they can hasten death. According to a standard view, the administration of analgesics and sedatives amounts to euthanasia when the drugs are given with an intention to hasten death. In this (...) paper we report a small qualitative study based on interviews with 8 Australian general physicians regarding their understanding of intention in the context of questions about voluntary euthanasia, assisted suicide and particularly the use of analgesic and sedative infusions (including the possibility of voluntary or non-voluntary 'slow euthanasia'). We found a striking ambiguity and uncertainty regarding intentions amongst doctors interviewed. Some were explicit in describing a 'grey' area between palliation and euthanasia, or a continuum between the two. Not one of the respondents was consistent in distinguishing between a foreseen death and an intended death. A major theme was that 'slow euthanasia' may be more psychologically acceptable to doctors than active voluntary euthanasia by bolus injection, partly because the former would usually only result in a small loss of 'time' for patients already very close to death, but also because of the desirable ambiguities surrounding causation and intention when an infusion of analgesics and sedatives is used. The empirical and philosophical implications of these findings are discussed. (shrink)

The moral importance of the ‘intention–foresight’ distinction has long been a matter of philosophical controversy, particularly in the context of end-of-life care. Previous empirical research in Australia has suggested that general physicians and surgeons may use analgesic or sedative infusions with ambiguous intentions, their actions sometimes approximating ‘slow euthanasia’. In this paper, we report findings from a qualitative study of 18 Australian palliative care medical specialists, using in-depth interviews to address the use of sedation at the end of life. The (...) majority of subjects were agnostic or atheistic. In contrast to their colleagues in acute medical practice, these Australian palliative care specialists were almost unanimously committed to distinguishing their actions from euthanasia. This commitment appeared to arise principally from the need to maintain a clear professional role, and not obviously from an ideological opposition to euthanasia. While some respondents acknowledged that there are difficult cases that require considered reflection upon one's intention, and where there may be some ‘mental gymnastics,’ the nearly unanimous view was that it is important, even in these difficult cases, to cultivate an intention that focuses exclusively on the relief of symptoms. We present four narratives of ‘terminal’ sedation – cases where sedation was administered in significant doses just before death, and may well have hastened death. Considerable ambiguities of intention were evident in some instances, but the discussion around these clearly exceptional cases illustrates the importance of intention to palliative care specialists in maintaining their professional roles. (shrink)

In an article somewhat ironically entitled “Disambiguating Clinical Intentions,” Lynn Jansen promotes an idea that should be bewildering to anyone familiar with the literature on the intention/foresight distinction. According to Jansen, “intention” has two commonsense meanings, one of which is equivalent to “foresight.” Consequently, questions about intention are “infected” with ambiguity—people cannot tell what they mean and do not know how to answer them. This hypothesis is unsupported by evidence, but Jansen states it as if it were accepted fact. In (...) this reply, we make explicit the multiple misrepresentations she has employed to make her hypothesis seem plausible. We also point out the ways in which it defies common sense. In particular, Jansen applies her thesis only to recent empirical research on the intentions of doctors, totally ignoring the widespread confusion that her assertion would imply in everyday life, in law, and indeed in religious and philosophical writings concerning the intention/foresight distinction and the Principle of Double Effect. (shrink)

The value of literature in medical education is widely accepted by medical teachers. There are examples of psychopathology in the characters of novels that provide illustrations of particular psychiatric diagnoses. Characters created by Charles Dickens, often eccentric, have been deemed to suffer from mental disorders. This may be because Dickens could draw on his extensive contact with Victorian psychiatry and interest in psychopathology to create authentic characters. He is widely acknowledged to have described many other medical conditions in his (...) fiction and his writing is already used to teach medical students. This article reviews Dickens’ contact with psychiatry and outlines the mental disorders possibly suffered by the characters under ICD 10 diagnostic headings. These descriptions, while interesting in their own right, may also prove useful to clinicians and teachers. (shrink)

Recently, the nature of science (NOS) has become recognized as an important element within the K-12 science curriculum. Despite differences in the ultimate lists of recommended aspects, a consensus is emerging on what specific NOS elements should be the focus of science instruction and inform textbook writers and curriculum developers. In this article, we suggest a contextualized, explicit approach addressing one core NOS aspect: the human aspects of science that include the domains of creativity, social influences and subjectivity. To illustrate (...) these ideas, we have focused on Charles Darwin, a scientist whose life, work and thought processes were particularly well recorded at the time and analyzed by scholars in the succeeding years. Historical facts are discussed and linked to core NOS ideas. Creativity is illustrated through the analogies between the struggle for existence in human societies and in nature, between artificial and natural selection, and between the division of labor in human societies and in nature. Social influences are represented by Darwin’s aversion of criticism of various kinds and by his response to the methodological requirements of the science of that time. Finally, subjectivity is discussed through Darwin’s development of a unique but incorrect source for the origin of variations within species. (shrink)

Douglas R. Anderson's Philosophy Americana reads like a series of rescue attempts: an attempt to rescue academic teaching from institutional and bureaucratic logic; to rescue philosophers such as Bugbee and Royce from their pragmatist critics; to rescue the pragmatists themselves from their would-be champions among the postmodernists; to (in a related move) save Emerson from Cavell; to save country music from the charge that it is either politically retrograde or an experiential dead-end; and to save Kerouac and the Beats (...) from the charge of nihilism or its more enjoyable cousin, hedonism. Anderson connects his chapters through a common theme: the centrality of failure and loss to American culture and the need to both be at home in/with it and to move beyond its self-limiting aspects. Though this rubric may provide us with a clue as to Anderson's temperament as a writer it does not finally provide an adequate frame for the book, which reads more like a book of related essays than... (shrink)

The central philosophical texts of this volume, the “metaphysical” or “cosmological” essays of the early 1890s published in The Monist, have long been a source of enjoyable controversy for Peirce scholars. From the reasonably straightforward arguments of “The Doctrine of Necessity Examined” to the wild and fascinating speculative suggestions in “Evolutionary Love,” Peirce marks out the transitional ideas of his mid-career. Whether one sees, as I do, a continuity among these essays and their predecessors and followers, or whether one reads (...) them as idiosyncratic efforts of a midlife Peirce, one is compelled to wrestle with their meaning. This alone makes the reading of Volume 8 of the Chronological Edition an .. (shrink)